Treatment of scaphoid fractures in a local hospital

Scaphoid fractures are common, but can easily be overlooked clinically. The purpose of this study was to determine the incidence of this injury and the treatment outcome for patients with scaphoid fractures in our department.

All patients with scaphoid fractures who were treated in the Orthopaedic Section of Haugesund Hospital from 1987 up to and including 2011 were included in the study. Data was gathered through review of patient records.

415 patients were included. 302 (73%) were men, and the average age was 35. The final outcome was known for 385 patients (93%), and only these were included in the analysis of the results. Cast immobilisation resulted in radiographic union in 281 of 308 cases (91%), and 26 follow-up operations brought the number healed up to 302 (98%). Seventeen patients received surgical primary treatment because of extensive displacement. After a maximum of two reoperations, all fractures were healed. Fractures were healed in 319 (98%) of a total of 325 patients who received appropriate primary treatment. 60 patients went without treatment for a long time. Fractures were healed in 41 (68%) of patients who had cast immobilisation followed by surgery in 38 cases. Non-union was found in a total of 66 patients (17%). 50 of the 66 non-union patients underwent surgery; the fractures of 84% of them were healed. The final outcome was healing of 360 of 385 patients (93%). 25 patients (7%) developed persistent non-union.

The result of plaster casting and surgery was satisfactory. The prognosis for scaphoid fractures that receive appropriate primary treatment is good, but many such fractures are only discovered at a late stage.